Are you trying to obtain a FAA medical certificate with asthma? In most cases, the process of obtaining a FAA medical certificate with asthma is relatively simple. As with all medical conditions, however, the FAA will assess your history and the current status of your asthma to determine whether your asthma and lung function presents any risk to aviation safety. In other words, the FAA will want to know whether your asthma is aeromedically significant. Most cases result in an applicant being issued an airman medical certificate under the FAA’s CACI criteria (which stands for “Conditions AMEs Can Issue”). However, some applicants with a history of more frequent and severe asthma symptoms may require monitoring via a special issuance authorization.
Applicants with mild or seasonal asthma can be issued a medical certificate by the AME, assuming certain criteria is met. More specifically, if an applicant meets the CACI criteria, the AME is authorized to issue to the applicant a medical certificate, no matter the class certificate applied for, if the applicant is found to be otherwise qualified. This is welcomed news for most, as the CACI program allows the AME to avoid deferring an applicant’s examination to the FAA for further consideration.
What are the CACI criteria? In order to be qualified under the CACI program, an applicant with asthma must procure a current, detailed clinical progress note from a treating physician or specialist. In order to be current, the detailed clinical progress note must be generated no more than 90 days prior to examination by the AME. Upon review of the treating physician note, the AME must note the following:
- The applicant’s treating physician finds the condition stable on current regimen and no changes recommended;
- The applicant’s symptoms are stable and well-controlled (either on or off medication);
- The applicant is utilizing acceptable medications; and,
- The applicant’s current pulmonary function tests are in acceptable range.
In the event the AME finds that any of the above criteria are not found to be acceptable, the AME will defer the applicant’s examination to the FAA for further consideration. Nevertheless, if an applicant is found CACI-eligible, applicants for first- or second- class must provide the above-referenced clinical progress note annually; applicants for third-class must provide the information with each required exam.
Applicants with frequent, severe, and/or a history of asthma which is outside of the FAA’s CACI criteria will need to achieve a special issuance authorization. A special issuance authorization is an exercise of discretion by the Federal Air Surgeon. In cases where a special issuance authorization is required, the FAA may expect the applicant to provide clinical progress reports at a greater frequency, as well as additional, indicated diagnostics, in order to monitor the applicant’s asthma to ensure ongoing stability and satisfactory treatment.
If you are applying for a FAA medical certificate with asthma, keep the following information in mind before you visit your Aviation Medical Examiner for examination:
- Ensure that you obtain a detailed clinical progress note from your treating physician or specialist prior to your examination with an AME. If you fail to produce a detailed clinical progress note within the period of time your AME has to submit your examination to the FAA, you may be at risk for having your application deferred to the FAA.
- In order to be CACI qualified, the FAA will expect that an applicant experiences symptoms no more than 2 days per week. If you experience symptoms more frequently, consider talking with your treating physician about how to better treat your symptoms prior to applying for a FAA medical certificate.
- The FAA expects that in order to be CACI qualified, the applicant should not have to use inhaled short-acting beta agonist (rescue inhaler) more than 2 times per week and the use of oral corticosteroids for exacerbations should be no more than 2 times per year within the preceding year.
- The FAA also expects that an applicant have had no in-patient hospitalizations and no more than 2 outpatient clinic/urgent care visits for exacerbations (with symptoms fully resolved).
- If you are using medication to treat your asthma, keep in mind that the FAA only finds the following acceptable:
- Inhaled long-acting beta agonist
- Inhaled short-acting beta agonist (e.g., albuterol)
- Inhaled corticosteroid
- Leukotriene receptor antagonist, (e.g. montelukast [Singulair])
- Monoclonal antibodies are not acceptable for FAA medical certification under the CACI program.
- The FAA expects that your pulmonary function tests will produce results showing your FEV1, FVC, and FEV1/FVC are all equal to or greater than 80% predicted before bronchodilators.
- Check out our episode on The Pilot Lawyer Podcast about FAA medical certification with asthma.
- If you would like to learn more about this topic, listen to our episode about FAA medical certification with asthma!
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